Provider Demographics
NPI:1760869853
Name:FOSTER, LAPRINCESS (LPC, CPCS)
Entity type:Individual
Prefix:MS
First Name:LAPRINCESS
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LPC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:LIZELLA
Mailing Address - State:GA
Mailing Address - Zip Code:31052-0964
Mailing Address - Country:US
Mailing Address - Phone:478-718-5396
Mailing Address - Fax:
Practice Address - Street 1:544 MULBERRY ST STE 309
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8288
Practice Address - Country:US
Practice Address - Phone:478-449-5545
Practice Address - Fax:478-254-9710
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
GALPC010205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor